School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK.
Faculty of Nursing and Health Sciences, Health and Community Participation Division, Nord Universitet, Namsos, Norway.
BMJ Health Care Inform. 2024 Sep 17;31(1):e101113. doi: 10.1136/bmjhci-2024-101113.
Most feedback received by health services is positive. Our systematic scoping review mapped all available empirical evidence for how positive patient feedback creates healthcare change. Most included papers did not provide specific details on positive feedback characteristics.
Describe positive feedback characteristics by (1) developing heuristics for identifying positive feedback; (2) sharing annotated feedback examples; (3) describing their positive content.
200 items were selected from two contrasting databases: (1) https://careopinion.org.uk/; (2) National Health Service (NHS) Friends and Family Test data collected by an NHS trust. Preliminary heuristics and positive feedback categories were developed from a small convenience sample, and iteratively refined.
Categories were identified: positive-only; mixed; narrative; factual; grateful. We propose a typology describing tone (positive-only, mixed), form (factual, narrative) and intent (grateful). Separating positive and negative elements in mixed feedback was sometimes impossible due to ambiguity. Narrative feedback often described the cumulative impact of interactions with healthcare providers, healthcare professionals, influential individuals and community organisations. Grateful feedback was targeted at individual staff or entire units, but the target was sometimes ambiguous.
People commissioning feedback collection systems should consider mechanisms to maximise utility by limiting ambiguity. Since being enabled to provide narrative feedback can allow contributors to make contextualised statements about what worked for them and why, then there may be trade-offs to negotiate between limiting ambiguity, and encouraging rich narratives. Groups tasked with using feedback should plan the human resources needed for careful inspection, and consider providing narrative analysis training.
大多数医疗服务机构收到的反馈大多是积极的。我们的系统范围综述绘制了所有可用的实证证据，说明积极的患者反馈如何推动医疗保健的改变。大多数纳入的论文没有提供关于积极反馈特征的具体细节。
通过（1）制定识别积极反馈的启发式方法；（2）分享带注释的反馈示例；（3）描述其积极内容，描述积极反馈的特征。
从两个对比数据库中选择了 200 条记录：（1）https://careopinion.org.uk/；（2）由 NHS 信托机构收集的 NHS 朋友和家人测试数据。初步启发式和积极反馈类别是从小样本中开发出来的，并进行了迭代完善。
确定了以下类别：完全积极的反馈；混合反馈；叙述性反馈；事实性反馈；感激性反馈。我们提出了一种描述语气（完全积极、混合）、形式（事实性、叙述性）和意图（感激）的类型学。由于模棱两可，有时很难将混合反馈中的积极和消极元素分开。叙述性反馈通常描述了与医疗保健提供者、医疗保健专业人员、有影响力的个人和社区组织互动的累积影响。感激性反馈针对的是个别员工或整个单位，但目标有时不太明确。
委托反馈收集系统的人员应考虑通过限制模糊性来最大化效用的机制。由于能够提供叙述性反馈可以使贡献者能够就对他们有用的内容和原因做出上下文化的陈述，因此在限制模糊性和鼓励丰富的叙述之间可能需要进行权衡取舍。负责使用反馈的小组应计划为仔细检查所需的人力资源，并考虑提供叙述性分析培训。
